Rule 4729:5-3-24 | Dispensing Dangerous Drugs to an Alternate Location.
(A) As used in this rule, "alternate location" means a location other than a patient or caregiver's address on file with the pharmacy that complies with the requirements set forth in this rule.
(B) This rule does not apply to a central fill pharmacy as defined in rules 4729:5-5-19 and 4729:5-9-02.13 of the Administrative Code.
(C) A pharmacy licensed as a terminal distributor of dangerous drugs may dispense dangerous drugs to an alternate location in accordance with this rule. An alternate location may include either:
(1) A pharmacy as defined in section 4729.01 of the Revised Code; or
(2) A location licensed as a terminal distributor of dangerous drugs or who is exempted from licensure in accordance with section 4729.541 of the Revised Code and all the following apply:
(a) The dispensing pharmacy maintains a record keeping system that provides accountability for the delivery, return, and, if returned, the disposal of all dangerous drugs dispensed in accordance with this division of the Administrative Code.
(b) There is clear and convincing evidence that delivery of a dangerous drug directly to the patient would result in:
(i) Danger or harm to public health or safety;
(ii) Danger or harm to the patient without increased involvement by a health care professional in the patient's drug therapy.
(c) The receipt, storage, control, and distribution of the dispensed dangerous drugs are in the full and actual charge of a health care professional licensed pursuant to Chapter 4715., 4723., 4729., 4730., 4731., or 4741. of the Revised Code and in accordance with the professional's scope of practice.
(d) There is a documented method in place to ensure compliance with rule 4729:5-5-09 of the Administrative Code.
(e) The dispensing complies with federal law, rules, and regulations.
(D) A terminal distributor of dangerous drugs that serves as an alternate location shall comply with the following:
(1) Maintain a record keeping system that will provide accountability for the receipt, disposal, and return of all dangerous drugs dispensed by the pharmacy in accordance with this division of the Administrative Code.
(2) Unless donated to a drug repository program pursuant to section 3715.87 of the Revised Code, a dangerous drug that is not distributed or administered to a patient shall either:
(a) Be returned to the dispensing pharmacy for disposal or, if applicable, returned to stock;
(b) Be disposed of in accordance the applicable rules set forth in this division of the Administrative Code.
(3) Only receive drugs from the dispensing pharmacy if there is clear and convincing evidence that the delivery of a dangerous drug directly to the patient would result in:
(a) Danger or harm to public health or safety; or
(b) Danger or harm to the patient without increased involvement by a health care professional in the patient's drug therapy.
(4) The location acknowledges that any patient specific dangerous drug dispensed by a pharmacy is the property of that patient, except that a dangerous drug that is not distributed or administered to that patient within six months of dispensation shall be deemed abandoned. A terminal distributor of dangerous drugs may do any of the following with an abandoned drug:
(a) Return the drug to the dispensing pharmacy for disposal or, if applicable, returned to stock;
(b) Be disposed of in accordance the applicable rules set forth in this division of the Administrative Code;
(c) Donate to a drug repository program in accordance with Chapter 4729:5-10 of the Administrative Code. For the purposes of meeting the requirements under division (H) of section 3715.873 of the Revised Code and rule 4729:5-10-06 of the Administrative Code, a terminal distributor of dangerous drugs that possesses an abandoned drug shall be deemed as the owner of the drug for the sole purpose of providing consent for the drug's donation to a drug repository program; or
(d) If dispensed by a pharmacy under common ownership and control as the receiving terminal distributor of dangerous drugs, the drug may be returned to stock in accordance with rule 4729:5-5-22 of the Administrative Code.
(5) Nothing shall authorize a terminal distributor of dangerous drugs to return to inventory or otherwise repurpose an abandoned drug for use on another patient, unless the terminal distributor:
(a) Operates a drug repository program in accordance with Chapter 4729:5-10 of the Administrative Code; or
(b) Returns the drug in accordance with paragraph (D)(4)(d) of this rule.
(E) The state board of pharmacy may restrict a site from acting as an alternate location if it has clear and convincing evidence that the activities of that location present the following:
(1) Danger or harm to public health or safety; or
(2) Danger or harm to the patient.
(F) No prescriber or pharmacy that provides a patient with a drug pursuant this rule shall charge any additional fees or require any additional monetary compensation for the dangerous drug.
(G) Paragraph (F) of this rule does not prohibit a prescriber or pharmacy from charging a patient for any of the following:
(1) The cost of an office visit or any expense related to the administration of a dangerous drug; or
(2) The cost of a dangerous drug dispensed by a pharmacy to a patient if paid for by the prescriber or pharmacy.
(H) Except as otherwise required by Ohio law, a patient or patient's caregiver shall have the exclusive right to determine if a pharmacy may sell or deliver dangerous drugs that have been dispensed by the pharmacy in the name of that patient to an alternate location.
Last updated April 1, 2026 at 2:42 PM
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